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Different association between renal hyperfiltration and mortality by sex
Author(s) -
Yoo Kyung Don,
Yoon HyungJin,
Hwang Seungsik,
Heo Nam Ju,
Chin Ho Jun,
Yang Seung Hee,
Joo Kwon Wook,
Kim Yon Su,
Lee Hajeong
Publication year - 2017
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12857
Subject(s) - medicine , hazard ratio , confounding , confidence interval , percentile , demography , renal function , multivariate analysis , mortality rate , proportional hazards model , statistics , mathematics , sociology
Aim Renal hyperfiltration (RHF) is a marker of early kidney injury that was recently shown to be a novel marker of mortality. However, it has no clear definition. In this study, we suggested an age‐ and sex‐adjusted RHF definition and explored the association between RHF and mortality by sex. Methods We analyzed data from individuals receiving routine health examinations from 1995 to 2009. RHF was defined as an estimated glomerular filtration rate over the 95th percentile matched for age and sex. Results A total of 114 966 individuals were included. During the 75‐month of observation period, 2559 (2.2%) participants died. Among those, 71.4% were men. Because sex and RHF had a significant interaction for mortality ( P for interaction < 0.001), we performed survival analysis according to sex. RHF was related to lower body weight and a higher proportion of cigarette smoking in men, whereas these relationships were not found in women. In the Kaplan–Meier curve, RHF was associated with higher mortality rate than non‐RHF in both sexes, but this relationship was more prominent in men. In the multivariate analysis, RHF remained as an independent risk factor for all‐cause mortality even after adjustment for confounding in men (hazard ratio, 1.34; 95% confidence interval, 1.12–1.59; P = 0.001). In women, RHF was not associated with increased mortality. Conclusions We demonstrated that RHF was a significant risk factor for mortality in men but not in women. The mechanisms and clinical implications of these different associations according to sex require a further clarification.